Monitoring the Session

SB 754

Middleton Informed Consent Bill Bars Employers From Penalizing Vaccine Refusal

Died in committee

Verdict: Smells

SmellsInitial review
Sen. Mayes MiddletonRSenate 11
Both charges, and why
Caption mismatch

THE TEXT

…“take an adverse action or impose any penalty against an individual”…

Bill text, introduced version (I)

The caption speaks only of informed consent before health care is provided. The body also bans any person, including employers, from penalizing someone for refusing a service or vaccine, which is a broad anti-mandate rule the caption does not name.

Caption mismatch
The hole

THE TEXT

…“service was administered that informed consent was voluntarily”…

Bill text, introduced version (I)

A practitioner sued for damages can defend by showing the patient said consent was voluntary. A patient pressured by a third party will often say exactly that, so the clause may shield the practitioner even though the bill says coerced consent is not valid consent.

The hole

Initial review · graded Oct 20, 2026 · Headline, summary and grade are analysis of the bill text, not a finding about any person · How we grade

Caption

relating to informed consent requirements before the provision of health care services.

Caption from analyzed text · version I.

Summary

Practitioners face at least $5,000 per violation. Their defense: the patient said consent was voluntary.

The bill bars anyone from coercing a person lawfully living in Texas into getting a health care service, including a vaccine, and requires a practitioner to get informed consent before treating that person. It reaches health care practitioners and facilities, and through its 'a person may not take an adverse action' rule it also reaches employers, schools and anyone else who might penalize someone for refusing a shot or treatment. On the ground, the attorney general can sue to stop violations, practitioners face at least $5,000 in damages per violation, and health care workers can claim a religious or medical exemption from facility vaccine requirements.

Labels

Labels: NEVER GOT A HEARING. Filed Jan 10, 2025 and referred to the Senate State Affairs committee. No public hearing. The bill died.

Receipt

The receipt

89R-SB754 · 2025-01-10

SOLD BY

+ 1 coauthor

ITEM

relating to informed consent requirements before the provision of health care services.

WHAT IT DOES

Practitioners face at least $5,000 per violation. Their defense: the patient said consent was voluntary.

The bill bars anyone from coercing a person lawfully living in Texas into getting a health care service, including a vaccine, and requires a practitioner to get informed consent before treating that person. It reaches health care practitioners and facilities, and through its 'a person may not take an adverse action' rule it also reaches employers, schools and anyone else who might penalize someone for refusing a shot or treatment. On the ground, the attorney general can sue to stop violations, practitioners face at least $5,000 in damages per violation, and health care workers can claim a religious or medical exemption from facility vaccine requirements.

CHARGES

[x] CAPTION MISMATCHanalysis confidence 50%

THE TEXT

…“take an adverse action or impose any penalty against an individual”…

Bill text, introduced version (I)

The caption speaks only of informed consent before health care is provided. The body also bans any person, including employers, from penalizing someone for refusing a service or vaccine, which is a broad anti-mandate rule the caption does not name.

[x] THE HOLEanalysis confidence 40%

THE TEXT

…“service was administered that informed consent was voluntarily”…

Bill text, introduced version (I)

A practitioner sued for damages can defend by showing the patient said consent was voluntary. A patient pressured by a third party will often say exactly that, so the clause may shield the practitioner even though the bill says coerced consent is not valid consent.

TOTAL

No fiscal note in the loaded record.

HISTORY

  1. Received by the Secretary of the Senate
  2. Filed
  3. Read first time
  4. Referred to State Affairs
  5. Co-author authorized
FILED UNDER

BIG PHARMA'S BILL

THE TEXT

…“failure to receive immunization in accordance with state law.”

Bill text, introduced version (I)

The bill bars any person from taking adverse action against someone for refusing a vaccine, cutting against vaccine mandates.

SPEECH AND LAWFARE

THE TEXT

…“who is the subject of the violation for damages in an amount of not”…

Bill text, introduced version (I)

The bill creates a private lawsuit against health care practitioners with a $5,000 minimum damages award plus attorney's fees.

Smells

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

CAMPAIGN PAID FOR BY

Donors

Texans for Lawsuit Reform PAC$1.14MRussell Gordy$300,000Kenneth Fisher$215,000

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Jul 6, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Texans for Lawsuit Reform PAC$1,140,000.00

Texans for Lawsuit Reform PAC

$1,140,000.00

Cash
$1,140,000.00
Paid by others
$0.00
Total
$1,140,000.00

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Dec 12, 2024 to Oct 21, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101009502, 101012383, 101061137, 101072395, 101072779.

Russell Gordy$300,000.00
Kenneth Fisher$215,000.00
Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Texans for Lawsuit Reform PAC

$1,140,000.00

Cash
$1,140,000.00
Paid by others
$0.00
Total
$1,140,000.00

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Dec 12, 2024 to Oct 21, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101009502, 101012383, 101061137, 101072395, 101072779.

Votes

No floor vote loaded for this bill.

Fiscal

No fiscal note in the loaded record.

How this was graded

Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.

Sources

Texas Senate · Filed Jan 10, 2025

02/07/2025 S Referred to State Affairs

Texas Legislature Online · Introduced

Data snapshot Oct 26, 2026 at 4:19 AM CDT. Grades, charges, quotes and corrections follow the published record.

Coauthors

Senate committee · State Affairs · Final status: Died in committee

Companion

HB 3472 by Olcott (identical)

Subjects

Civil Remedies & Liabilities

Health Care Providers

Health--General

Health--Other Diseases & Medical Conditions

INFORMED CONSENT

ATTORNEY GENERAL

Text

The text as introduced · 1,212 words

89R2091 JDK-D

By: Middleton
S.B. No. 754

A BILL TO BE ENTITLED

AN ACT

relating to informed consent requirements before the provision of

health care services.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. The legislature finds that:

(1) this state is responsible for ensuring individuals

lawfully residing in this state have the right to provide or

withhold consent for any health care service;

(2) the decision in Canterbury v. Spence , 464 F.2d 772

(D.C. Cir. 1972), establishing the concept of informed consent, has

become a bedrock principle of the laws of this country and of each

state;

(3) the American Medical Association's Code of Medical

Ethics Opinion 2.1.1 recognizes an individual's right to be fully

informed of a recommended health care service allowing the

individual to make an informed decision regarding the individual's

course of treatment, including whether to obtain or decline a

particular health care service;

(4) under 42 C.F.R. Section 482.13, a hospital is

required as a condition of participation in Medicare to establish a

process for obtaining the informed consent of a patient before

providing a health care service to the patient and to ensure "[t]he

patient or his or her representative (as allowed under State law)

has the right to make informed decisions regarding his or her care";

(5) the United States Supreme Court, in Jacobson v.

Massachusetts , 197 U.S. 11 (1905), upheld mandatory vaccination

policies imposed by state and local governments to combat smallpox,

and in PruneYard Shopping Ctr. v. Robins , 447 U.S. 74, 81 (1980),

acknowledged a state may provide "individual liberties more

expansive than those conferred by the Federal Constitution";

(6) any attempt to compel or coerce an individual

lawfully residing in this state into obtaining a health care

service contrary to the individual's preference is inconsistent

with the principles of informed consent; and

(7) Chapter 174, Health and Safety Code, as added by

this Act, prohibits any person from compelling or coercing an

individual lawfully residing in this state into obtaining a health

care service, including the administration of vaccines.

SECTION 2. Subtitle H, Title 2, Health and Safety Code, is

amended by adding Chapter 174 to read as follows:

CHAPTER 174. INFORMED CONSENT REQUIREMENTS FOR

HEALTH CARE SERVICES

Sec. 174.001. DEFINITIONS. In this chapter:

(1) "Health care facility" means a facility licensed,

certified, or otherwise authorized to provide health care services

in the ordinary course of business.

(2) "Health care practitioner" means an individual who

holds a license, certificate, or other authorization to engage in a

health care profession in this state.

(3) "Health care service" means a service a health

care practitioner or health care facility provides to an individual

to diagnose, prevent, treat, alleviate, cure, or heal a human

health condition, illness, injury, or disease. The term includes

the administration of a vaccine.

Sec. 174.002. EFFECT ON OTHER LAW. (a) To the extent of a

conflict between this chapter and other law, this chapter controls.

(b) The requirements provided by this chapter are in

addition to another applicable requirement for a health care

service provided by other law.

Sec. 174.003. PROHIBITED COERCION TO OBTAIN HEALTH CARE

SERVICE. A health care practitioner or another person may not

coerce or compel an individual lawfully residing in this state into

obtaining a health care service contrary to the individual's

preference.

Sec. 174.004. REQUIRED INFORMED CONSENT. (a) Except as

otherwise provided by other law, a health care practitioner may not

provide to an individual lawfully residing in this state a health

care service unless the practitioner obtains the informed consent

of the individual or a person authorized to consent on behalf of the

individual, including:

(1) a guardian in accordance with Chapter 1151,

Estates Code;

(2) an individual authorized to provide consent under

Section 32.001, Family Code;

(3) a parent in accordance with the rights and duties

described by Section 151.001, Family Code; and

(4) an agent under a medical power of attorney in

accordance with Chapter 166.

(b) For purposes of this section:

(1) an individual lacks the capacity to provide

informed consent for a health care service if the individual has

been coerced or compelled into obtaining the service; and

(2) a health care practitioner who advises or

recommends a health care service is not considered to have coerced

or compelled the individual into obtaining the service based solely

on that advice or recommendation.

Sec. 174.005. PROHIBITED ADVERSE ACTION. A person may not

take an adverse action or impose any penalty against an individual

lawfully residing in this state for the individual's refusal or

failure to obtain a health care service, including a refusal or

failure to receive immunization in accordance with state law.

Sec. 174.006. EXEMPTION FROM HEALTH CARE SERVICE

REQUIREMENTS FOR CERTAIN INDIVIDUALS IN HEALTH CARE FACILITIES. An

individual who is employed by, providing services in, or receiving

training in a health care facility that requires the individual to

obtain a health care service is exempt from the required service if

the individual requests orally or in writing an exemption based on:

(1) a sincerely held religious belief, observance, or

practice that is incompatible with the administration of the

service; or

(2) a recognized medical condition for which the

service is contraindicated.

Sec. 174.007. INJUNCTION. (a) The attorney general may

bring an action for injunctive relief against a person to prevent

the person from violating this chapter. In an order issuing an

injunction under this section, a court may include reasonable

requirements to prevent further violations of this chapter.

(b) The attorney general may recover court costs,

reasonable attorney's fees, investigation costs, witness fees, and

deposition expenses incurred in bringing an action under Subsection

(a).

Sec. 174.008. CIVIL LIABILITY. (a) A health care

practitioner who violates this chapter is liable to the individual

who is the subject of the violation for damages in an amount of not

less than $5,000.

(b) The prevailing party in an action brought under this

section may recover reasonable expenses incurred as a result of the

action, including court costs, reasonable attorney's fees,

investigation costs, witness fees, and deposition expenses.

(c) A health care practitioner may assert as an affirmative

defense to an action brought under Subsection (a) that the

individual who is the subject of the violation on which the action

is based or a person legally authorized to consent on behalf of the

individual stated to the practitioner before the health care

service was administered that informed consent was voluntarily

provided.

SECTION 3. Chapter 174, Health and Safety Code, as added by

this Act, applies only to a health care service provided on or after

the effective date of this Act.

SECTION 4. If any provision of this Act or its application

to any person or circumstance is held invalid, the invalidity does

not affect other provisions or applications of this Act that can be

given effect without the invalid provision or application, and to

this end the provisions of this Act are declared severable.

SECTION 5. This Act takes effect immediately if it receives

a vote of two-thirds of all the members elected to each house, as

provided by Section 39, Article III, Texas Constitution. If this

Act does not receive the vote necessary for immediate effect, this

Act takes effect September 1, 2025.